The commitment shown by the NHS workforce has captured public interest throughout the pandemic in a truly unique way. A national outpouring of support for health and care staff was symbolised through pictures of rainbows in windows and weekly rounds of applause. The public's admiration for the work that NHS staff do has never been more apparent, but the workforce is exhausted.
After a gruelling first peak, the NHS is now facing a second wave of the virus, with high infection rates likely to persist alongside winter pressures in the coming months. The outbreak of COVID-19 in England placed extraordinary demands on the NHS, which have been met with an extraordinary response. Innovations were brought about at a rapid pace during the initial peak of the pandemic, across almost every aspect of health and care services. Despite being implemented in an incredibly short time frame, many of these changes, if sustained, have the potential to deliver long-term benefits – for staff, patients, and services.
Innovations were brought about at a rapid pace during the initial peak of the pandemic, across almost every aspect of health and care services. Despite being implemented in an incredibly short time frame, many of these changes, if sustained, have the potential to deliver long-term benefits – for staff, patients, and services.
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However, this will require careful analysis and proper implementation. In this blog we explore the key findings of NHS Providers' new briefing, Workforce flexibility in the NHS: Utilising COVID-19 innovations, which reflects trust leaders’ appetite to take this forward and sets out how it can be done.
NHS Providers' recent survey found that 99% of trust leaders are either extremely or moderately concerned about the current level of burnout across the workforce. From wellbeing hubs, to free tea and coffee, trust leaders have been working harder than ever to support their staff. Whilst many of these initiatives have been made possible by public donations and additional temporary funding, this is not a reliable stream of financial support. Appropriate central funding is vital for local wellbeing schemes to continue, so that trusts are not forced to choose between staff wellbeing and investing resources in frontline care.
Appropriate central funding is vital for local wellbeing schemes to continue, so that trusts are not forced to choose between staff wellbeing and investing resources in frontline care.
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In the longer term, to truly protect the wellbeing of the NHS workforce, more staff are needed not only to cover existing workforce gaps, but also to build flexibility into the system: wellbeing is best protected by realistic workloads, more regular and reliable breaks, and better work life balance. This is a longstanding, structural challenge for government and both national and local NHS organisations, but given the level of burnout among staff now, funding to ensure the recruitment and retention of NHS staff in sufficient numbers has never been more vital.
COVID-19 has also brought into sharp relief the risks of long-standing health inequalities. The disproportionate effect of the virus on Black, Asian, and minority ethnic people, including those working in health and care settings, quickly became clear during the outbreak's initial peak. NHS leaders and staff have sought to understand the actions that can be taken to address these issues within their organisations, not only in the face of COVID-19, but with the ultimate aim of confronting structural racism within the NHS. There is plenty more learning to be done, and far more changes to be made to address these inequalities, but COVID-19 has cemented this as a key priority for the NHS going forwards. National and local initiatives to address racial inequality in the NHS must empower and protect Black, Asian, and minority ethnic people, without prescribing "one size fits all" solutions or putting the onus of change upon Black, Asian and minority ethnic staff.
National and local initiatives to address racial inequality in the NHS must empower and protect Black, Asian, and minority ethnic people, without prescribing "one size fits all" solutions or putting the onus of change upon Black, Asian and minority ethnic staff.
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The need to increase workforce capacity for the delivery of COVID-specific care brought about particularly practical innovations. We have seen reduced bureaucracy in staff deployment across the NHS, increasing opportunities for staff to work flexibly and develop skills in new areas. We have seen medical and nursing students fast-tracked, and NHS retirees returning, to the front line. We have seen increased collaboration across the health and care system, enabled in large part by simplified regulation. We have seen a step change in the use of virtual consultations and remote working. Changes which would ordinarily have taken years to enact instead took months, or even weeks.
The speed at which workforce innovations and flexibilities have been implemented in the NHS since the outbreak of COVID-19 has been both impressive and encouraging. These changes must be captured and codified into policy and practice to ensure that the valuable lessons learned are not lost.
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